Managing Diabetes During Pregnancy

 

Gestational diabetes mellitus (GDM) is a type of diabetes that develops during pregnancy and usually resolves after childbirth. It occurs when the body cannot produce enough insulin to meet the increased demands of pregnancy, leading to high blood sugar levels.

According to the World Health Organization (WHO), gestational diabetes affects up to 1 in 6 pregnancies worldwide, and its prevalence is rising, particularly in South Asian countries like Pakistan. Factors such as genetics, lifestyle, and increasing maternal age contribute to this growing health concern.

Early detection and proper management are crucial, as uncontrolled gestational diabetes can pose serious health risks for both the mother and the baby.

Symptoms of Gestational Diabetes

Gestational diabetes often develops without noticeable symptoms, which is why routine screening during pregnancy is essential. However, some women may experience:

• Increased thirst and frequent urination
• Fatigue or weakness
• Blurred vision
• Nausea or vomiting
• Frequent infections, especially urinary or skin infections
• Excessive weight gain during pregnancy

 

Since these symptoms may resemble normal pregnancy changes, they are often overlooked, making regular prenatal screening the key to early detection.

When to See a Doctor

All pregnant women should undergo screening for gestational diabetes, usually between the 24th and 28th week of pregnancy, or earlier if they are at high risk.

You should consult your doctor if you:

• Have a family history of diabetes
• Experienced gestational diabetes in a previous pregnancy
• Previously delivered a baby weighing more than 4 kg (9 lbs)
• Are overweight or obese before pregnancy
• Have polycystic ovary syndrome (PCOS)
• Are older than 30 years at the time of pregnancy

 

Early consultation allows timely diagnosis and management, helping prevent complications for both mother and baby.

Causes and Risk Factors

During pregnancy, hormones produced by the placenta can cause insulin resistance. When the pancreas cannot produce enough insulin to overcome this resistance, blood glucose levels rise, resulting in gestational diabetes.

Major Risk Factors Include:

• Family history of Type 2 diabetes
• Overweight or obesity before pregnancy
• Previous history of gestational diabetes
• Sedentary lifestyle
• High blood pressure
• Unhealthy diet high in sugars and refined carbohydrates
• Belonging to high-risk ethnic groups, including South Asians

 

Diagnosis

Gestational diabetes is diagnosed through blood glucose testing during pregnancy. Common diagnostic tests include:

• Oral Glucose Tolerance Test (OGTT): Performed after fasting, followed by drinking a glucose solution to measure how the body processes sugar
• Fasting Blood Glucose Test: Measures blood sugar levels after an overnight fast

 

If blood glucose levels are higher than normal, the doctor confirms gestational diabetes and begins appropriate management.

Treatment and Management

The primary goal of treatment is to maintain blood sugar levels within a healthy range to ensure the well-being of both mother and baby.

1. Dietary Management:

• Eat balanced meals with whole grains, fruits, vegetables, and lean proteins
• Avoid sugary foods, processed snacks, and refined carbohydrates
• Divide meals into smaller, frequent portions throughout the day
• Consult a dietitian for a personalized meal plan

2. Physical Activity:

• Engage in moderate exercise such as walking, prenatal yoga, or swimming, as advised by your doctor
• Physical activity helps improve insulin sensitivity and stabilize blood sugar levels

3. Blood Sugar Monitoring:

• Regularly monitor blood glucose levels using a glucometer as directed by your healthcare provider

4. Medication (If Needed):

• If diet and exercise are insufficient, insulin therapy or safe oral medications may be prescribed

5. Regular Prenatal Care:

• Frequent checkups help monitor maternal and fetal health and ensure proper baby growth

 

Complications of Gestational Diabetes

When managed properly, most women with gestational diabetes have healthy pregnancies. However, uncontrolled blood sugar can lead to complications.

For the Baby:

• High birth weight (macrosomia)
• Premature birth
• Low blood sugar (hypoglycaemia) after birth
• Breathing difficulties
• Increased risk of obesity and Type 2 diabetes later in life

For the Mother:

• Preeclampsia (high blood pressure during pregnancy)
• Increased likelihood of caesarean delivery
• Higher risk of developing Type 2 diabetes in the future
• Recurrence of gestational diabetes in future pregnancies

 

Prevention

Although not all cases of gestational diabetes can be prevented, the risk can be reduced through healthy lifestyle choices.

Prevention Tips:

• Maintain a healthy body weight before conception
• Eat a balanced, nutrient-rich diet
• Exercise regularly before and during pregnancy, as approved by your doctor
• Avoid excessive weight gain during pregnancy
• Attend regular prenatal checkups and blood sugar screenings

 

After Delivery

In most cases, gestational diabetes resolves after childbirth. However, both mother and child remain at higher risk of developing Type 2 diabetes later in life.

Postnatal Care Recommendations:

• Get blood sugar testing 6 to 12 weeks after delivery
• Continue diabetes screening every 1 to 3 years
• Maintain a healthy diet and active lifestyle
• Encourage breastfeeding, which supports maternal glucose control and infant health

 

Conclusion

Gestational diabetes is a manageable condition when detected early and treated appropriately. With proper diet, regular physical activity, and consistent medical supervision, most women can have safe pregnancies and healthy babies. If you are pregnant or planning to conceive, consult your doctor for routine screening and guidance. Early awareness and timely care can make a lasting difference for both mother and child.